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Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Wednesday, June 29, 2011

In a 7-2 decision handed down on Monday, the US Supreme Court struck down California’s violent video game law and ruled that video games are protected speech covered by the First Amendment. The California law banned the sale and rental of violent video games to minors.

The underlying question was whether the violence in video games has the ability to affect children more than violence in other media, such as books, movies, plays and other forms of entertainment.

Justice Antonin Scalia, writing for the majority, said that depictions of violence have never been regulated by the US government. Thus violent videos are not to fall under government control as does pornography but is to be accorded the same First Amendment protections as other forms of entertainment. The sale of violent video games is not to be criminalized and California’s attempt to do so was “unprecedented and mistaken.” Scalia noted, referring to fairy tales, that “the books we give children to read—or read to them when they are younger—contain no shortage of gore.”

The beginning of the decision states, “Video games qualify for First Amendment protection. Like protected books, plays, and movies, they communicate ideas through familiar literary devices and features distinctive to the medium. And ‘the basic principles of freedom of speech…do not vary’ with a new and different communication medium.”

“The most basic principle—that government lacks the power to restrict expression because of its message, ideas, subject matter, or content, Ashcroft v. American Civil Liberties Union, 535 U. S. 564, 573—is subject to a few limited exceptions for historically unprotected speech, such as obscenity, incitement, and fighting words. But a legislature cannot create new categories of unprotected speech simply by weighing the value of a particular category against its social costs and then punishing it if it fails the test.”

The justices were not convinced by the existing research that the interactive nature of video games pose a greater risk to society because of their interactive nature. None of the results of the existing research put before the court showed that violent games cause violent behavior. “Psychological studies purporting to show a connection between exposure to violent video games and harmful effects on children do not prove that such exposure causes minors to act aggressively. Any demonstrated effects are both small and indistinguishable from effects produced by other media. Since California has declined to restrict those other media, e.g., Saturday morning cartoons, its video-game regulation is wildly under-inclusive, raising serious doubts about whether the State is pursuing the interest it invokes or is instead disfavoring a particular speaker or viewpoint.”

According to Nadine Kaslow, professor and chief psychologist at Emory University Department of Psychology and Grady Hospital, the evidence regarding the effects of violent video games is mixed. While there is evidence to suggest that exposure of children to violence results in more aggressive and less pro-social behavior, some studies show there is no negative effect, she said. She point out that toy guns were popular and parents monitored whether toy guns were allowed in the home.

This ruling does not prevent private retailers from placing restrictions on their sale of video games. The video game industry currently has its own rating system, much like that used for movies, and educates retailers in using the rating system to prevent minors from buying mature-rated games. According to PC World the industry’s compliance is better than that of other entertainment industries. Further, parental controls have been added to game consoles.

The view of the Entertainment Software Association that a better strategy is the education of parents rather than court battles.

Wednesday, August 16, 2006

Google on Wednesday inaugurated a free city-wide Wi-Fi system in its home town of Mountain View, California. Google insisted that it had no plans to offer a similar service nationwide. Most residents of Mountain View, can connect to the Internet via a Mesh Wi-Fi network for free. Google said that its network “eventually will cover the entire city” and serve as “testing ground for future innovations.” The network is currently setup in downtown Mountain View, and much of the suburbs are yet to be hooked up.

The wireless network (Wi-Fi) covers 90% of Mountain View. It offers maximum data transfer rate of up to 1 Megabit per second, which is slightly slower than DSL.

The system costs about US$1 million to build and uses 380 transceivers mounted on street-lights throughout the 31 km² city. Reviews of the network say that it works smoothly in open areas, but that connections can be patchy in enclosed spaces.

Chris Sacca, Google’s head of special initiatives, said that “the main purpose of his company’s backing local wi-fi access is to clear the way for broadband entrepreneurs and overcome legal roadblocks by established telephone and cable TV providers”.

Mountain View, which has about 72,000 residents, is the largest U.S. city with totally free Internet access available throughout the entire community.

Wednesday, August 5, 2009

Four people have been shot and killed and at least 15 wounded when a gunman opened fire inside a LA Fitness center in Bridgeville, Pennsylvania. The gunman was among the dead.

Reports say the man walked into a dance room where an all-female Latin dance class was in session, turned off the lights and began to shoot people. CNN reports that the gunman was a “middle-aged white male.” One witness said he was carrying a duffel bag, which he put down before shooting into the crowd. After opening fire, he turned the gun on himself. At least 30 people are reported to have been in the room at the time of the shooting.

Allegheny County police Superintendent Charles Moffatt said, “I’ve never seen nothing quite like this. It was very chaotic. […] There’s a good belief that the shooter is deceased.”

Collier Township Police Chief Tom Devin stated that the police, “believe the shooter committed suicide at the scene but we’re not positive.” Police report that the shooter’s motive may have been a domestic dispute with one of the exercisers.

Mike Hentosz, a witness who was inside the gym, said, “I feel like it’s a dream. I don’t know what to think of it.” A woman participating in the class, Nicole, said that 10 minutes into the class, “a middle-aged white male walked into the class. He had a big gym bag. […] He looked out of place in a class full of women.” When he began firing, she reported, she ran out of the gym and escaped in passerby’s car.

Thursday, October 5, 2006

The Independent Monitoring Commission has reported that the Provisional Irish Republican Army has undergone major changes within their military structure and shows that the IRA Army Council wants to put its military campaign behind it. The Commission consists of John Alderdice, a former Alliance Party leader; Joe Brosnan, former Secretary General of the Department of Justice, Republic of Ireland; John Grieve, former Deputy Assistant Commissioner of the Metropolitan Police and former head of the Metropolitan Police Anti-Terror Branch; and Dick Kerr, former Deputy Director of Central Intelligence Agency.

The report states the IRA no longer has the capacity to mount a military campaign anymore or return to one. The units that have been shut down were responsible for weapons-making, arms smuggling and training. The IRA decommissioned their arms last year.

The report also mentions that the IRA has also put its criminality beyond use and is “clamping down” on criminals within the organization, said Lord Alderdice, as he presented the report. He also added, “That doesn’t mean that criminal activity by all members has stopped but the leadership has made public statements and internal directions, investigated incidents of breach of the policy, even expelled some members and has emphasised the importance of ensuring that business affairs are conducted in a legitimate way.”

Finally, the report added that there is not enough evidence or intelligence to identify who killed Denis Donaldson, a British spy who infiltrated the IRA and Sinn Fein, before revealing his status as a spy.

However, the report added that splinter groups like the Real IRA (RIRA) and Continuity IRA (CIRA) are still threats and are still continuing their activity. The Real IRA was the group behind the deadly 1998 Omagh bombing. The Irish National Liberation Army (INLA) “was not capable of undertaking a sustained campaign [against the British State], nor does it aspire to” according to the report.

It is also noted the creation of two new organizations, Oglaigh na hEireann (Irish Gaelic for “Volunteers of Ireland” and is used by the Irish Defence Forces and the various IRAs.) and the Republican Defence Army. However, the groups are small dissident factions according to the report.

The report also added that the two loyalist paramilitaries, the Ulster Defence Association (UDA) and the Ulster Volunteer Force (UVF) are also beginning to move from violence but at slower pace and not at a grassroots level like the IRA. Another loyalist paramilitary, the Loyalist Volunteer Force

The report was received warmly by Irish Toaiseach Bertie Ahern and British Prime Minister Tony Blair. Ahern, said “These positive and clear-cut findings are of the utmost importance and significance. It is time to make decisions and for Northern Ireland to look to the future.”

“The IRA has done what we asked it to do, and while issues like policing remain to be solved, the door is now open to a final settlement, which is why the talks next week in Scotland are going to be so important.” said Tony Blair in a live statement.

In a surprising reaction, the notoriously hardline leader of the Democratic Unionist Party, Ian Paisley, also welcomed the report. He believes that his party’s pressure is working and if Sinn Fein signs up to policing there could be a deal. Paisley said, “If the police question is settled absolutely on a democratic basis and principle we would have come a long way along the road.”

Sinn Fein leader Gerry Adams said “The DUP don’t have anything other than very limited options. They will or will not participate in power-sharing arrangements. If they don’t participate they are condemning people here, but particularly their own constituents, to second class public services, run by second class fly-in, fly-out British ministers. All the DUP can do is to delay, is to attempt to slow down, but they can’t stop the process of changing.”

Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

Sunday, June 12, 2005

A Russian passenger train has been derailed by an explosion on Sunday, the FSB has said in a statement. A FSB spokesman said 12 people have been injured, when two carriages of a train heading from the Chechen capital Grozny derailed 90 miles south of Moscow.

Officials have reported that two people have been rushed to hospital, while others who sustained lighter injuries were offered medical assistance at the crash site and delivered to Moscow by commuter train. The spokesman did not say who might be responsible for the attack on the train, which at the time was carrying more than 300 passengers.

Only an hour prior to the incident, a train carrying elementary school pupils from Beslan, North Ossetia on their way to Croatia passed on the same track. 56 children were heading to a Moscow airport, from where they flew to Zagreb. In September last year, 172 children died in the Beslan school hostage crisis.